General Functional Medicine
If someone is getting a lot of cramps, they might do well to supplement with calcium. Can you talk a little bit about this? For most of my life, I was told cramps was a salt issue and you should eat more salt if you got cramps a lot. Then for a few years, I was under the impression that it was actually a magnesium deficiency, that sodium and calcium help muscles to contract and magnesium and potassium help muscles to relax. So hearing that frequent cramps is due to calcium deficiency is very new to me. Can you explain the physiology?
Kelsey Marksteiner: I don’t usually use exogenous calcium unless I absolutely have to with someone just because of some of...
What strategy do you take with patients presenting with significantly low melatonin, like 1.2 on a scale of 10 to 50 being normal? She asked if we supplement with melatonin, melatonin precursors, or foods containing melatonin.
Dr. Amy Nett: So this depends a little bit. I would say is the patient having sleep problems? So if...
In terms of the saliva cortisol awakening response hack, I like the idea. But to be really accurate, wouldn’t you have to do it every five minutes like Mark Newman did, unless you missed that rise? He has his rises five to10 minutes after waking, I think he said. So that would mean buying several tests. It seems like quite a cost. Why is it so hard for labs to provide this?
Dr. Amy Nett: Well, that’s a great question. I wish I knew why labs weren’t routinely providing a test kit...
I would like to ask about chronic vaginal yeast infections. Client is 25 years old, has chronic vaginal yeast infections for the past three years since moving to Vancouver Island from Alberta. She says she gets about one per month, but they don’t correlate with her cycle. She eats bread daily or nearly daily. She also drinks beer on the weekends. She’s a pescatarian. She has started taking probiotics, but they’ve had no effect. I suggested she cut bread and limit beer. I’m wondering if doing a gut workup is called for here, although I’m pretty sure she doesn’t have the funds to pay for all the testing. Do chronic vaginal yeast infections point to yeast overgrowth in the gut or elsewhere in the body? Please give me any info you can on treatment of chronic yeast infections.
Chris Kresser: Yeah, absolutely. This fits in with what I was just saying about the connection between the oral microbiome...
I just started treating a patient with similar symptoms to frequent yeast infections, and it turned out to be something called cytolytic vaginosis, which is a vaginal overgrowth of Lactobacillus. Most things I read about talked about increasing pH with baking soda, but I’m wondering if there is a probiotics approach.
Chris Kresser: Yeah, I would still consider some of the oral treatment that we talked about and also some of...
A follow-up question on pediatric antimicrobial protocol versus adult protocol: What age do you switch from pediatric to adult?
Chris Kresser: Probably not until 10, 11, 12, would I start thinking about adult protocol at maybe lower doses. Pediatric...
A client of mine has had difficulties in swallowing food, especially things like canned tuna. Things like canned tuna all their life and feels the need to drink water with every meal. The patient also deals with slight acid reflux every once in awhile by drinking a glass of water. Is there such a thing as lifelong insufficient saliva production? How would you go about treating it?
Dr. Amy Nett: Insufficient saliva production, I don’t know, I’m not sure about that. But I would think about...
If someone goes off opiates for pain management and rheumatoid arthritis. Given it’s autoimmune, what do you recommend for support, specifically pain inflammation and reducing to your regulatory cells?
Dr. Amy Nett: Number one, low-dose naltrexone. So the patient’s not already on low-dose naltrexone? That would probably be the...
Do you always start slowly with antimicrobial doses and build up to the recommended dose?
Chris Kresser: We do. That’s kind of a basic component in the instructions that we provide to patients when they...
There was an organic acids test, you said there was one in particular in which organic acids was used every time, including the first test. I’m still trying to understand when you would bring that in and why it was decided in this particular case from the get-go. Every time this patient retested, there wasn’t much improvement, so I wondered why that test was used three times. There weren’t any clear symptoms that would call for his test that I could tell. The case ended up going for mercury testing, but that was after a lot of organic acids tests.
Dr. Amy Nett: Part of our initial workup, Chris and I are still mostly doing this for initial consults, maybe...
